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The OCD Whisperer Podcast with Kristina Orlova
182. OCD + ADHD: Why It Feels So Much Harder Than It Should
00:38:10
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- [00:00]
A
Welcome to OCD Whisperer podcast. Here we talk about ocd, anxiety and mental health. And if you like these kind of conversations, please remember to subscribe and turn that notification bell on. And today with me, guys, I have Dr. Rachel LaFleur, and we're gonna be talking about ADHD and OCD.
- [00:16]
B
Welcome to the show, Christina. Thanks for having me back.
- [00:20]
A
Absolutely. If anybody doesn't know or remember at all, which I'm not gonna expect people to, but can you tell us a little bit about yourself?
- [00:28]
B
Yeah, yeah.
- [00:29]
A
And your experience?
- [00:30]
B
I'm a licensed psychologist. I'm very proudly based in Baltimore, Maryland. But I also have authorization to protect practice telehealth to most states in the United States through psypact. I have a couple specializations. One is ocd. I'm really passionate about treating OCD for children, adolescents and adults. And then additionally I have some specialization to support parents in what's something called behavioral parent training, which I use with kids for a. I guess I'd say a greater variety of concerns.
- [01:03]
A
Awesome.
- [01:05]
C
Hi, I'm Christina Orlova, host of the OCD Whisperer podcast. As someone who lives with ocd, I understand the struggles firsthand. If you're here, you're not alone. Before we start, grab your free OCD survival kit at www.corresults.com to help you take control. That's K O R results dot com. Now let's dive into today's episode.
- [01:33]
A
Well, I know you and I connected because we were talking a little bit about specifically this overlap between ADHD and ocd. Um, I know that, you know, for. I know that sometimes both clinicians and. Or the person may not fully recognize or understand the symptoms. So I'm wondering if you can tell us a little bit about kind of that overlap or how each one might present and present together and separately.
- [02:00]
B
Absolutely. And I think to sort of, in my response, kind of want to begin the story in talking about what gets missed in childhood. So right now we're seeing about 50% of people with ADHD are getting diagnosed as adults, where not many years ago, just a few decades ago, this was considered a pediatric only condition. And it was actually really conceptualized around hyperactive boys. And so we're seeing a lot of women and girls being missed, especially ones who do a lot of what I'd say high masking, who have either other skills or qualities that they're using to manage their ADHD before being diagnosed or treated, as well as sometimes people with anxiety or OCD might, that might push them to mask and compensate even More making them harder to spot, to diagnose, to treat. And so sometimes in the folks that I'm treating who have ocd, when they're meeting with me, they might have been even screened for ADHD or done a psychological evaluation and it might have been missed. And they might have been in OCD treatment for years with multiple clinicians and they're meeting with me and I think I'm getting a spidey sense that there might be some ADHD here. And what's so interesting about it, Christina, is that one of the things that can happen with ADHD is it can be hard to use what you know, meaning knowledge and skills can be hard for you to activate in and to put into place in your life. And if someone's been in evidence based treatment for OCD and gathered knowledge and skills for managing their ocd, they might have been having a hard time putting those skills into practice. So, so sometimes one of the biggest things I do for someone is help spot adhd, get the right evaluation from a psychiatrist or neuropsychologist and then from there that medication piece in and of itself can be the thing that helps someone to put into place what they know. And so this. Oh, sorry.
- [04:05]
A
Yeah, I was going to say what are the spidey senses? Cause now my, my interest is peaked. Like what are those, what are those things you see or you might notice?
- [04:13]
B
Yeah. And so I think when we're thinking about this like prototypical ADHD case, a lot of us are thinking about boys who are hyperactive. I think when it comes to people who are missed, they're probably less likely to be, to show hyperactivity. So they're less fidgety, perhaps they might be somewhat less impulsive. Seeming to other people may have a harder time with organization. They might, however, then compensate by being really organized in some ways, but still sometimes. So it's like really tricky. Other things I'm noticing is people who have a high, what I'd say performance variability. They can be really highly attentive and focused on things that are of high interest. But when they're moving into an area, maybe it's administrative tasks in their job or an activity they find boring, especially boring and effortful. All of a sudden attention and organization can be that much more challenging, or maybe that's the only place it's challenging. I think we think about ADHD attention deficit, that it's a deficit across the board where it's really more variability in the self regulation, including attention and organization as well as other processes. So sometimes you'll meet someone with ADHD and they're doing so well, they're in life in certain areas, but depending on the day, all of a sudden their performance might jump up or down more than other people or the area of their life. So, again, it's this performance variability I'm also noticing with people with adhd. I'd say boredom is a more salient emotional experience. When we think about anxiety and ocd, we understand fear and worry are salient emotions that people want to avoid. For someone with adhd, boredom is. Is also a salient emotion. And so these are people who might, you know, I'll hear people kind of joke like, I'm allergic to administrative tasks. Like, I hate them, I don't want to do them, or I make my spouse do this for me because I really can't stand doing it. And I hope you're noticing, too, as I'm talking about these things. These aren't things that are like, people without ADHD experience these things too, which, again, makes it harder to spot, because it's not that any one of these things points to adhd. It's a combination of them. And with. With enough symptoms presenting and enough impairment presenting now, it becomes diagnosable.
- [06:39]
A
Well, that's exactly honestly where I went, right? Because I'm thinking, well, wait, I know people who are like, yeah, I don't like doing this administrative stuff, or I'm not good at, I don't know, let's say tech stuff, or I'm not good with social media or whatever it is that somebody isn't good at or just isn't excelling as well. So, of course, naturally, I think humans, we want to kind of say, like, oh, can I just give it to somebody else? And there may be better just. Just somebody else handle it, period. It doesn't mean it's adhd. So what's that? Because, and I have to be honest, for people listening here, this is a little bit out of my wheelhouse. So I'm not. I don't specialize in adhd, like you were saying. Like, I know some basic common things. Things like, you see some hyperactivity. Some things are pretty obvious from what we've known these days, right? So I'm thinking about those things. When you could see that somebody maybe is jumping around into a lot of different conversations, or you could see that somebody's very fidgety, or they're moving around a lot or they're having to do a lot of different things. Things like that are, I think, the more obvious things. But you're mentioning that there's things that you might not pick up that are not so outwardly obvious in that way. And in fact, when somebody might actually have an issue around organization or things like that, but they will overcompensate. So like you said, masks, right? So now I'm like, wait a minute, I'm getting a little confused then. So how would you put, what cluster, how would you put this together to say, okay, this seems to meet that or.
- [08:05]
B
Right.
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A
Because again, I'm always thinking of people listening. Yes, obviously they're gonna be listening for, oh my God, do I have that? Is that going on for me? So what, what, what are some things that somebody would be looking for?
- [08:16]
B
I think, number one, if, if you're wondering if it could be you, I think it's worth bringing it up with someone that you can talk it through with. I think another point just to add to the confusion here is that people with adhd, per research, have a harder time spotting and seeing their own adhd, especially, especially up through young adulthood. And so people with ADHD might not see their ADHD where people around them might see it. So I think this needs, these conversations need to happen with other people, with clinicians, with people you're close to and trust, and starting to ask, like, do I have adhd? If I do, where do you see it? And then pursuing an evaluation or talking to a psychiatrist, if you have a mental health clinician working with them as well, a therapist. But I think in terms of things that are a little bit quieter, things that, that are less obvious, I think it's not just like when it comes to adhd, there's these really high achieving folks that when you say, hey, tell me what it looks like for you to manage all of the work on your plate, then all of a sudden you can start to see where the ADHD lies, the level of compensation they have to do to really, whether it be really late nights, have to have someone else there when they're studying, otherwise they won't, you know, and you really kind of have to look at what they're putting in to achieve the results. They are, I think other things that are subtle, some of these are kind of jokes that people make. People with ADHD might have a closet full of materials for different projects and hobbies that they aspire to do. Things that are started but not finished. And then they get excited about the next craft project, get all the supplies, put it in that area. That area is probably disorganized, could use a deep clean, but with ADHD can get really excitable about something and have a hard time looking into the future and thinking through if they're going to follow through or if there's something else they should be doing instead. So that's an example. Women and girls, in terms of their hyperactivity. There's some research that suggests that that's more readily spotted in verbal behavior instead of physical behavior. So these are people, just like you said, when they're answering a question, they might meander, they might have a harder time with conversational turn taking. People with ADHD sometimes find themselves very understandably bored when someone is essentially sort of speaking through a paragraph and they know based on the first sentences, they can predict where it's going. They're kind of eager to jump in and respond even though the person hasn't finished.
- [10:48]
A
So like, they might interrupt more often or stuff like that. Yeah, I've heard of. What's the word? You probably know it better. It's escaping me right now. But they're like little pile dumps or what are they called like that. You might see some of those. What is it called?
- [11:01]
B
What's the word? People do call people, talk about their piles. Right. That people just sort of have dump spots. Piles just have a harder time sort of organizing sometimes their physical environment. And I think some of these things we can see externally through behavior. But it also speaks to what's happening internally that someone with ADHD just like in their physical space, there's like piles everywhere and they're like, I know where everything is. You're like, but this doesn't make sense to me.
- [11:28]
A
Yeah, like things could be clean and fine, but then you'll have areas where it's like a little something here, a little something there, a little something there. You're like, wait, no, no, but I know what it is. Or, yeah, I'll clean it up. But it could take a second. But it's like these little clusters will.
- [11:40]
B
Yes. And I think it speaks to what's happening cognitively, where there's someone who has maybe a system that they're working through. It may not always work particularly well for them. They're getting along, though. But internally they might have a harder time sort of moving around in their mind, how they're going to move through their schedule even, or accomplish all the tasks in their mind, sort of holding all of that idea, all those ideas in their mind and sort of, oh, oh, I wasn't able to accomplish this by this time. How should I reschedule new things in my day to Prioritize certain things, what should move to tomorrow. These tasks can be harder for someone with adhd. You know, along those lines too is I think what's really tricky is one of the things that can really help with ADHD but also can painful for relationships is it's accountability. So having someone else around you who can help you to follow through can be a really important thing. At the same time, making sure that that's done in a helpful, supportive way because otherwise that creates conflict and strain on relationships. So sometimes you'll spot a sign that someone might have ADHD is really kind of counting or relying on other people to help them get out to work on time, move through different routines, get different administrative tasks complete, so on and so forth.
- [12:59]
A
So I'm gonna throw a little curveball. I know we talked about adhd, nocd, but for a minute, you know, my mind kind of goes to a little bit of hoarding. Just curious, have you seen something like that or do you know any much about that?
- [13:13]
B
Yeah, I don't specialize in hoarding and so I hesitate to answer and, but I mean, I'm so tempted to like go down that path with you because I see what you mean of this physical environment and, and, and having a lot of stuff. I will say it wouldn't surprise me if, if there's a relationship between ADHD and hoarding, generally speaking, we tend to see that ADHD creates a higher likelihood of different mental health diagnoses, including OCD and related disorders. So just wanted to put that out there.
- [13:48]
A
But yeah, okay.
- [13:49]
B
I think we need more research about the specific overlap of OCD in certain conditions. I think sometimes that's missing a hundred percent.
- [13:56]
A
Yeah. And so, okay, let's talk about OCD for a minute. So if somebody has both and you're, you're working through an evidence based practice for ocd, so you're like, okay, let's, you know, whatever the therapy is, let's, let's start with, let's say psycho education, let's take the next step and so on. But the person has adhd, what is it that you know, you could see, see that will get in the way. Because that's kind of what I'm getting from what you're saying is that they basically can go through various providers for OCD and the work can be fine and the providers are great, but if this thing isn't diagnosed, they're not going to really be able to take it and use it. So you're just going to end up like going through these cycles of doing therapy again and again and kind of, I guess it could feel like, like it's not effective, but it's like, no, what's not effective is that we're missing a piece of, of what else is showing up here. So, I mean, I get it. What you're saying is, okay, let's get your proper diagnosis, but let's say somebody, let's, let's go two scenarios. One is, somebody doesn't have the diagnosis, what do you do then? Do you do like, do you just stop the OCD treatment for now and say, hey, hold on, I think something else is going on. And then let's go through the next scenario, which will be, let's say you have all that, then how would you augment or how would you change treatment?
- [15:19]
B
Yep. So first I just want to say that in terms of the research we have, we now have decades of research on ADHD and best practices for treating it. And above and beyond. We know medication is foundational to the treatment of ADHD. However, not everyone responds to medication. About 70% of people respond really well to medication. About 30% of people just don't like the way it feels. There's not good side effects or they're simply not a responder. So research tells us that is a starting place. ADHD is a neuro biological condition. It is so linked to genetics that the influence of genetics on ADHD is similar to genetics on height.
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A
Okay.
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B
If you look around your family, you know, there's a level of being able to predict, you know, how tall people are going to be. It's the same for adhd. There's some studies that say if one parent has adhd, the likelihood of their child having adhd. Some studies put it lower, but I've sort of landed on a statistics that's more than 50%, 50 to 60% likely. So more than half. So it's really genetic. And so neurobiological condition needs a neurobiological treatment. So I do think it's important to have these conversations early. And if someone's suspecting adhd, they really need to bring in a team of people to look at this question. I think from there, because essentially what I'm saying is for some people, you know, medication, stimulant medication, particular research tells us that, and again, not stimulants are not a fit for everyone. But research tells us that stimulant medications are much more effective than non stimulants. So it's a starting place. If stimulant medications work, it should feel like it should be life changing. I mean, that's what we're going for. And it should feel like putting glasses on, like putting glasses on your brain. And so that stimulant medication may be a prerequisite to effective treatment. It may be the thing that kind of breaks the case wide open, as you say. So I'm wanting to have that conversation and I'm wanting to work with someone and say, hey, should we keep working through this as you're working through medication? Do you want to work with someone on medication? Come back to me. I think this is just where we have like a collaborative conversation where we're thinking about, you know, the different benefits and risks of different approaches. I say more of the time, people stick around while they're working through the medication piece. Especially with adults, I'd say they tend to go to a psychiatrist rather than do a full neuropsychological evaluation, which tends to be efficient but less thorough in terms of an evaluation. And then we're just sort of building a relationship and getting things going when someone's not on a stimulant medication. What I'm doing is I'm really wanting to be flexible with their, the style they want from me. Do they want me to help be extra structured in treatment so that they are more likely to be able to take the things from our appointments and put them into practice, for example, getting really specific on homework. Am I helping them to set alarms for when they're going to do their homework? Or will they really begrudge that and that will put a bad taste in their mouth for therapy? And we're going to find something that's more flexible, something that we're going to try to find a way to have it more naturally, sort of, I call it, like, live within them to create a new lens for which they're experiencing themselves in the world. And I want to talk that through with people because again, I think this should be a collaborative process. And if we're assigning homework and structured homework and they're not completing it, I don't want therapy in this experience and therapy to another. This to be another place that really contributes to a person's sense of, like, shame. Because I think people with adhd, particularly undiagnosed, untreated adhd, come from a place of like, understandably, the world's not understanding what they're experiencing. They're not understanding what they're experiencing. They're perceiving this to be like a motivation deficit. Like, why can't I just work hard enough at this. And I don't want this experience to be another thing that adds to that sense because I don't want therapy to be demoralizing. I want people to feel like it fits where they're at and like, if we can lift them up and forward.
- [19:27]
A
So let me ask you a scenario. So let's say you're working with somebody. Like, everybody knows it's adhd. Let's say that they don't. They, they have the medication, but they just don't want to take it. Because sometimes people don't.
- [19:36]
B
Absolutely.
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A
And they, you know, they're showing up, they're. You're going through like, you're learning stuff, right? They're like, yes, yes, yes. I def. Like, I mean, you could tell, obviously they're very interested, they want to. But then when you meet and you're noticing, you know, after a little bit, you're just not making any traction because even though the desire is there, they want to. But, you know, when, when it comes to actually doing it on their own or, you know, sitting down or kind of reviewing things or applying or anything like that, everything just kind of falls apart.
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B
Yeah.
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A
What do you do?
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B
Yeah, there's a few different things that I try and we do a trial and error process and we try different things out and we, we look for something that works. One thing that I'll try is let's take those skills and let's practice them in an appointment. Like, I think we talk a lot about what to do, but we're not always saying, let's do that, live together here. And I think, you know, there's a variety of ways of doing that, but I think even one skill to practice is like an attention training technique. It's one thing to talk about, for example, unhooking from rumination. It's another thing to practice different versions of that in an appointment and take something that we've sort of spoken about in an abstract way and make it concrete. And then to have someone voice with you in an appointment, here's where that got heard for me. Let's practice it. And then I think when you're assigning something as homework, let's, let's like give people where we can some wins so they get some momentum in treatment. And so I think, for example, again, talking about rumination and I bring that up, by the way, because ADHD tends to want to grab a. Of hold. Hold of something, of course, that takes your attention and things that are emotionally charged capture our attention with adhd. So you're sort of Looking at this thing that's emotionally charged, and a lot of techniques and treatment require you to shift your attention off of this and back into your life. That's going to be harder for adhd. And on top of that, because they're staying in this, it almost renews its emotional activation. So there's this, like, sort of staying hooked. And then this is where people. The thing that's scary or frustrating kind of reactivates them and.
- [21:46]
A
Right.
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B
And then it's even harder to shift your attention from it. And you could see how that relates to ocd, of course, but also so many other things in mental health. So, like, then in an appointment, like, let's practice this together so that one, that someone can start to be especially fluent and masterful on this skill. And then when we're exporting it outside of therapy, I think sometimes it helps to. For someone to practice doing it at a. For a smaller, easier window of their day, get masterful at that, and then grow their practice of that to. And like, export it to other parts of their day and then into more of their day. So again, just breaking it down into something more achievable.
- [22:28]
A
Absolutely. So, like, give me a concrete example. What are you doing? So, okay, you're having the person, let's say it's me. So what would you have me do to practice this? Like, give. Give me a life example.
- [22:37]
B
And so, like, I would say, like, what's a part of your day that, number one, you could see yourself reaching for therapy stuff? Okay, we've got it. Okay, do you want to set an alarm or are you going to pair this with that activity? And every time you sit down for that activity, you're going to do it. Okay, you. You prefer pairing it with the activity. Okay, so you're choosing during dinner time to practice unhooking from. From rumination. Okay, so. And, and why are you choosing that time? Oh, well, my friends are usually with me or I'm. I'm with my family. And that's a time where my brain isn't as busy. And so I think I'm going to be able to be successful at this. Okay, sounds great. And then this is where I might say, okay, are you willing? I know, I know. It's a big ask. Are you willing to, like. Because I don't want to do this. Like, this is not what I'm drawn to either. Are you willing to, like, log the experience for me? And I think this is where, number one, this creates some accountability because. And accountability is really helpful for all of us to through in our goals. But it's especially important for people with adhd. Things that help people with adhd, by the way, help all of us. They're just that much more important for someone with adhd. So then this log comes into the appointment and then so now that helps them be like, oh, well, I don't want to not have something for Rachel. And so I'm going to fill out my log. Number two is it helps with this sort of process of sort of reflecting on the experience of how did it go? Well, number one, did you do it? How did it go? If it was hard, why do you think it was hard? And then I'll usually have them write something for themselves as like, what do you want to try the same or differently next time based on what you learned? And this creates this, like, trial and error process of taking the things from therapy and putting them into practice. Now, I think the thing that's really worth mentioning though is essentially this is a form of behavioral intervention that me serving as an accountability partner is really helpful. But when I exit the system, it can be hard for this person and to maintain any sort of practice of like, logging things or reviewing. And so when it comes to adhd, whether it's medication or behavioral intervention, as soon as those things are stopped, the ADHD returns. And so this is where we have to create different sort of strategies to help someone remember to do things. Whether or not there's like an app that keeps them organized, they're setting alarms, they have someone in their life who's reminding them that for people to maintain the sort of momentum, someone either medication and, or some of these environmental supports are helping them through.
- [25:14]
A
Well, and you're talking about creating routines, not like OCD compulsions, but, but better, healthier routines and kind of flows. And I imagine because you're talking about like attention training and doing even something small like, okay, I'm noticing I'm here, like in my head, and I'm going to actively, once I see it, choose to turn my attention to here. And here might be the conversation I'm in, or here might be I'm actually washing dishes or oh, I'm having my food, or what, whatever it is, right? But actively, really consciously working on finding a small window of time where they're going to say, okay, for, I don't know, five minutes. I'm going to practice essentially noticing when I kind of go, go into my mind, I'm kind of out there somewhere. Notice that, say, oh, wait, stop and come, come back to this moment. Essentially and reconnected the here now and then basically take some notes on that. Like did I do it? Did I not do it? Was I successful some of the time? Not at all. And so over time that just even those practices together are building that awareness, that muscle. Um, so it's like helping them. Yeah, like you said, get some accountability. But also with the OCD piece because a hundred percent we know people with OCD rumination is one of the big things we all can get stuck on. And I mean rumination is something we as people generally we ruminate. But it sounds like, you know, I, I definitely know people without OCD or ADHD or anything else can cut that off a lot faster.
- [26:42]
B
Yes. And I think the other thing that's helpful and I'm so glad for the OCD clinicians out there, anxiety clinicians who understand accommod of anxiety and ocd, we understand that family members can play a really important role and other loved ones in mental health treatment. I think that can be true for supporting someone with adhd, that if the person with ADHD wants some support, maybe if they are seeming to like it's called co rumination when you're doing it with another person, do they want a reminder if it's happening during dinner and say, oh, is that ruminating? Like is there something that person to do? Do they want that person to ask, hey, did you fill out your log today? Or would that just feel really icky for that relationship? Please don't like, let's respect that too. But I think it's just really important to have these sorts of conversations. Other things I just really wanted to point out, by the way, just like while I'm here and have a bit of a soapbox is I just wanted to say like I love how much conversation is happening around adhd, including on social media. But I made sense, but also my jaw dropped a little bit when I learned of a study that showed that about 50% of social media content on ADHD is incorrect. So really important. I know I did not know that.
- [27:57]
A
I'm like, that's huge.
- [27:58]
B
Really important for people to know that whether wherever they're getting information on adhd, there's a lot of well intentioned but not accurate information out there, including about what's helpful for treatment. So I just want to put out there that it's really important to go to like reputable sources. And I will say my favorite person for understanding the research on adhd, not my favorite person for all aspects of learning about ADHD, but understanding the research on ADHD is Dr. Russell Berkeley. And he's been really preaching about ADHD for a long time when people didn't believe it was a real condition. And he has books as well as a very active YouTube channel, including where he dispels some misinformation from frankly trusted publications at times on his YouTube channel. And so I always recommend people start with him and then it kind of helps you to scrutinize other information from an evidence based place. I will say, however, Dr. Barkley has been at this for a long time. What a win on the downside is, you know, he's been waving the flag, take this seriously. And so the way he talks about ADHD is from a place of how it can really take away from people's lives when it's not managed. So it's not necessarily speaking about it from like a strength based or affirming place in the same way as I think a lot of us have come to be used to. But he's my favorite place to start. I have not personally listened to, but I've heard good things about the ADHD experts podcast. And so that's another place potentially to go. There's also different websites, but I'll even say with some of the well known advocacy websites, I see some information that is to me, to my eye, based on the available research, isn't really always up to speed.
- [29:45]
A
Got it. Okay. Well, thank you for sharing that. I mean, that's a huge number. To be honest, I'm a little bit shocked to hear that. I mean, I know that online, you know, things get missed, misinterpreted, misrepresented. But, but that's just, that's a pretty big number in terms of actually having some concrete research behind it. I have one last question for you. So we talked a bit about, you know, what some symptoms and things that can be missed, subtle things. We talked a bit about things that are shown to be effective. Like medication really is a really important starting point. Like 70% of people get significantly better. Like it's life changing. Then there's behavioral changes. But I also wanted to ask, you know, what, what, what in your experience do you notice loved ones commonly see, right. People around people who have ADHD that maybe is or isn't diagnosed. What are the, what are the common things they might say? Like oh, this person, like you go off onto tangents or like what you interrupt a lot or what you seem like you're focused and then you're not. Like what are some of those things?
- [30:48]
B
I think one of the things, especially like people who are really close to someone with adhd is this sense of confidence that comes from being able to direct yourself on a path and achieve that. Like, I just think that that's so important for us as humans to feel like we can do that. And I think that you can have this sense of confidence and ease in yourself when that's taken care of. I also think with people who are spending a lot of time with each other, I think the other thing is just the partnership that can come from someone who, you know, if you're thinking about spouses, they're. They're basically, you know, running a little family corporation with each other of just the partnership that can come from assigning all the different tasks to both parties instead of this person can do these ones, this person does these ones. I think that can be really changing, too. And I think the other thing is just once one family member understands they have adhd, it creates a pathway for other people in the family to end up being diagnosed, too. And so it's been. One of the most heartwarming things is when I'm talking to parents of a child who I suspect may have adhd, I bravely say, and that means if we. If your child ends up being diagnosed and you feel confident in that diagnosis, that means likely at least one of you has adhd. Do you. Have you all thought about which one or both of you, they have it. And then all of a sudden, parents are sometimes themselves getting diagnosed and come back and say, my life has changed. Like, thank you for pointing that out. And so it can change whole families.
- [32:35]
A
And so what would friends see? Like, what are the behaviors that people will see?
- [32:39]
B
People with less time blindness. Time blindness is.
- [32:46]
A
So I want to actually jump in before you continue, because again, people listening might not know what that means. So what does time blindness mean?
- [32:52]
B
Yep. So time blindness, I think people talk about it a couple different ways. Time blindness is just, number one, just having a harder time keeping track of the time and managing themselves with the schedule and people arriving. So people with ADHD maybe, again, huge variability in this, but might be more likely to be late, more likely to maybe cancel last minute. But I also think there's sort of a time blindness in terms of people with ADHD tend to have more of a focus and prioritization of the present self over the future. Them who maybe like me right now, would love to watch another episode of this or do this or do an ocd compulsion, but future me is going to regret that. There tends to be. I mean, we all tend to prioritize to some degree our future selves at different times, people that are prone to doing that more. So that's also sort of another time blindness. And so friends might see that people are again following through with their goals and commitments to themselves, a bit more, more organized, again on time. Might see a bit more conversational turn, taking sharing in conversation a little bit differently. Adhd, too. A big part of ADHD is emotion dysregulation. And so by treating the ADHD itself, you can see less of the emotions that fuel mental health challenges as well as sometimes conflict. And so sometimes people with medicated ADHD perhaps might appear more patient in different situations or just a little bit more, I don't know, like, again, just sort of moving through things with a little bit more flow as opposed to things that may have agitated them, bothered them other times.
- [34:43]
A
So they could be like a little more irritated or even angry or something like that. And then once they get that treatment, it's like, oh, I can actually have. I feel like there's more space. Like I can listen fully or not jump and interrupt, or I can be more on time or I can suddenly organize my day better. I can stay focused or do different things. And yeah, I think when I talk
- [35:04]
B
to people with adhd, one of the signs where I'm like, is this. ADHD is when people express a lot of regret for things that they, they said or, you know, especially like women in particular. Kind of like, I do really well with my friends, but I, I just keep falling to the same trap with my partner. And I can't believe I said that again. I feel like I was so mean. Why do I keep doing that? And you're just like, oh, right, well, this is a uniquely intimate relationship. If you have adhd, you have more emotion dysregulation. And here it is again, too, I think, like with adhd, another hot topic is something called rejection sensitivity. Rejection sensitivity is the name for the fact that people with ADHD may get in, have a sense of insecurity that comes from people misunderstanding them, giving them a lot of critical feedback, and sometimes just feeling like people don't again get it. And so this is where people with ADHD may be really sensitive to perceived rejection or criticism from other people. And again, sometimes you might see that in close relationships, even a therapy relationship with a clinician. Again, there's a lot of variability on what this looks like. Some people are really just internalizing this and feeling bad about themselves. Other people might feel irritable or angry around other people. And for children, you'll see kids with ADHD are more likely to perceive neutral interactions as as negative. So if you think about a child in class who's not paying attention, as a lot of kids in class aren't doing, a child with ADHD who's like, hey Christina, go ahead and focus again, they might say to their parents later, I got yelled at. Get yelled at in school by the teacher. You're so mean to me. They don't like me. And so that speaks to some of the rejection sensitivity that can happen.
- [37:02]
A
Amazing. There's so much in there. Rachel, thank you so much for coming on the show and sharing all this. So for people that are listening today, if they would like to find you, how could they find you?
- [37:12]
B
They can find me on my website. Stoneyrunpsych.com S T O N Y R U N p s y c-h.com Beautiful.
- [37:21]
A
Thanks so much for coming on the show.
- [37:23]
B
Yeah, thank you for hosting. This is such a great resource for people. I appreciate it.
- [37:30]
C
Thanks for listening to the OCD Whisperer podcast. Remember, freedom from OCD is a journey and you're not alone. Visit www.coraresults.com to explore self help masterclasses like Sneaky Rituals with Jenna Overbaugh or ICBT Masterclass with Christina Inabe. Don't forget to grab your OCD CBT journal tracker and planner while you're there. If you found this episode helpful, please subscribe, share and leave a five star review to help others find the pot Podcast. Together we can make a difference. Keep going and I'll see you in the next episode.